title: Single-stage omental flap transposition: modality of an effective treatment for deep sternal wound infection.
abstract: Deep sternal wound infection (DSWI) is an uncommon life-threatening complication of cardiac surgery performed through median sternotomy. Surgical treatment is considered complicated and challenging. We report our experience with a single-stage omental flap transposition in the treatment of the 14 consecutive patients who were diagnosed with DSWI within 3-16 days after the primary cardiac surgery, between August 2001 and January 2008. The single-stage omental flap transposition was achieved within 70-135 min, at four to eight hours after diagnosis of DSWI. The single-stage omental flap transposition was successfully applied and all 14 patients survived. They displayed a shortened intensive care unit stay (one to nine days) and hospital stay (19-36 days). Follow-up was 100% complete (26-92 months) and demonstrated rapid recovery, complete wound healing without fistula, and no late gastrointestinal complications. However, the very few complications found were slight numbness of anterior chest and minor paradoxical chest movement. We obtained satisfactory outcomes when treating the patients with DSWI by a single-stage omental flap transposition. Based on our solid experience, we recommend this procedure as an option for patients with DSWI, especially those who are not in a state of severe low cardiac output or malnutrition.
authors.affiliation: Department of Surgery, Prince of Songkla University, Hatyai, Songkhla 90110, Thailand. cvoravit@yahoo.com
authors.forename: Voravit
authors.initials: V
authors.lastname: Chittithavorn
authors.forename: Chareonkiat
authors.initials: C
authors.lastname: Rergkliang
authors.forename: Apirak
authors.initials: A
authors.lastname: Chetpaophan
authors.forename: Teera
authors.initials: T
authors.lastname: Simapattanapong
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D003646:Debridement; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008480:Mediastinitis / Q000382:microbiology / Q000601:surgery*; D008875:Middle Aged; D009852:Omentum / Q000601:surgery*; D056346:Sternotomy / Q000009:adverse effects*; D013524:Surgical Flaps / Q000009:adverse effects; D013530:Surgical Wound Infection / Q000382:microbiology / Q000601:surgery*; D013785:Thailand; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing
chemical_list: D000900:Anti-Bacterial Agents